Chapter 23 Reframing I can t do it A Practical Exercise We are upset not by things but the view we take of them Epictetus Saturday afternoon. Reframing distressing thoughts is a practice that helps you begin to see repeating patterns in your life and the interconnection between your thoughts and emotions. To start, you need to learn to cultivate mindfulness of your thoughts themselves, with a non-judgmental attitude, and begin to recognize the distorted thoughts that tend to create emotional turmoil. Ultimately, by reframing distressing thoughts, you can reduce your stress and despair, and rest more often in your natural state of calm and compassion. Tim begins his lecture pointing to the three-column table up on the screen. Mindful of Distressing and Automatic Thoughts Inquiry and Insight What emotions follow this way of thinking? Is this a helpful or harmful thought? Is this thought exaggerated or irrational? Kind and Rational Response The three column technique for reframing distressing thoughts is based on the work of Dr. David Burns, a psychiatrist who wrote the classic book Feeling Good. Dr. Burns shows that distorted thinking 122 The Healing Circle
patterns can actually cause you to feel depressed and anxious, and that when you train yourself to think more clearly in a rational and realistic way, you will experience greater self-esteem, and more joy and intimacy in your relationships. More recently this psychological approach has been combined with the ancient practice of mindfulness into mindfulness-based cognitive therapy. This therapy have been proven effective in many different conditions, and modern neuroscience shows that the pathways and activity in your brain actually change when you teach yourself to reframe distressing thoughts. It s easiest to learn this technique by taking real-life situations and examining how your thoughts affect your emotions, and how to view the situation from a wiser and more compassionate perspective. The following example is based on a situation in which someone, going through chemotherapy, is physically tired and emotionally raw. In addition to the truth of the situation, the person thinks to himself or herself It s no use. I don t have the strength to get through this. In the left column in the table below, under the heading Mindful of Distressing and Automatic Thoughts, the person would write down their distressing thought: Mindful of Distressing and Automatic Thoughts It s no use. I don t have the strength to get through this. Inquiry and Insight What emotions follow this way of thinking? Is this a helpful or harmful thought? Is this thought exaggerated or irrational? Kind and Rational Response The first step in reframing is to be mindful of a particular distressing thought (left column). By writing it down, it is easier to recognize what we have been saying to ourselves. The second step (middle column) is to investigate this thought carefully by asking ourselves what emotions follow from this way of thinking, whether the thought is helpful or harmful, and in what ways the thought may be exaggerated or irrational. The third 123 Reframing I can t do it
step (right column) is to use a kind and rational approach to reframe the thought. Tim asks the group to reflect on the question: How is the thought separate from the situation? Tim explains The situation is that the person is very tired, they have suffered side effects of treatment and they are feeling depressed and upset. The thought It s no use. I don t have the strength to get through this is extra. It s a conclusion, and it causes additional suffering. When we see that thought coming up and realize it is not helping, we can actually start working with the thought itself. So next Tim invites the group to consider the questions in the middle column, under the title Inquiry and Insight. He asks: What sorts of emotions follow from this way of thinking? The group comes to life. A flurry of single-word answers to Tim s question echoes in the room: defeat, despair, frustration, helplessness. Tim points out that all these emotions can cause us to feel like giving up. He then mimics someone suffering from depression. He slumps forward towards his laptop, his arms folded over his heart, face down, hiding a frown - demonstrating that giving up has both psychological and physical effects. Tim asks Is this feeling of helplessness actually helping? A quick staccato of No No No - No. Someone adds It s knocking the person s energy down. It s harmful. The last question in the middle column is Is this thought exaggerated or irrational? Tim adds This is a tricky question. So pretend to be a lawyer. How would you pick holes in the logic of the distressing thought if you were in court? How would you say the thought isn t quite right? In what way is the thought exaggerated beyond the truth of the situation? Cheryl Ann, who now leads a national charity and has worked with a difficult cancer and side effects of her therapy for years, begins, You can t say that you don t have the strength to do this, because this is the first time you ve done this there s not been a before. Tim responds, Right. This is all new territory and the fact is that you are getting through this. You re here; you re alive. Therefore, it s actually not really true. You do have the strength. Anne is trying to get her life on track after being treated for ovarian cancer with surgery and chemotherapy. Initially, that may be how you feel from there you can possibly find the strength. I might find a deeper well to draw from. 124 The Healing Circle
Tim replies Yes! That is a beautiful image of new possibilities. You don t want to freeze the situation into a thought or make it true just because you believe it. These thoughts have a lot of power to shape your ongoing experience. If you look closely, you see that the truth is always shifting and changing, never frozen. The group is starting to see through the black or white thinking implied in It s no use. I don t have the strength. Tim outlines the idea of relaxing into the experience of not knowing what s going to happen and reminds the group about becoming comfortable with the unknown. When we panic in the face of the unknown, we tend to generate a lot of thoughts to create an illusion of knowing what s going to happen. This can cause further distress, especially if we have been conditioned to think about worst-case scenarios. This way of thinking can become what is called the fortune-teller error predicting one s demise. The fact is that we don t really know what s going to happen in the future, and so it is better to learn to relax with that truth. Otherwise, thoughts like I can t cope and It s no use do not help and actually make you feel worse. Tim guides the group to the right column, and to step back from the distorted thought and look at the whole situation from rational perspective, creating a reframe that is both wise and kind. He asks What would a loving grandmother say if you shared the distressing thought It s no use. I don t have the strength to get through this. Is there a way to reframe this way of thinking? After a long pause, Cheryl Ann volunteers a reframe, I have to get through this. It s non-negotiable. I ll just have to do it! Tim is quick to caution about using that tone of voice with oneself. That sounds like it puts a lot of pressure on you. That s kind of like the pushy angry parent that says, You have to do that. But you could say I will get through this or I can get through this. The specific words that you use are very important, because when you re talking to yourself like that you can feel pressure. Be careful of should and have to, right? When you say I will or I can it s much kinder to yourself and therefore more encouraging and effective. Trudy, a retired flight attendant who struggled with leukemia for years, asks, Is it OK to acknowledge that this is a difficult time? Oh, for certain. Tim continues It s very important to be honest 125 Reframing I can t do it
about how you feel, even about your level of despair. To begin, own your emotions completely. Feel them, and then look at what you can do. Trudy follows up. Oh. So, I don t have to do everything all at once. I don t have to eat the whole elephant today. Tim smiles and continues on this theme. No, you don t have to! Most important is to be kind to yourself and to pace yourself. Dr. David Burns, who introduced this technique, used the example of imagining all the meals that you eat in your whole life placed in a football stadium. If you were asked to eat all that food, you d say, Oh my god, I could never eat all that food! But the truth is that over your lifetime that s how much food you will eat. So when you break up the challenge into little bits, it becomes workable and you don t overwhelm yourself you can take baby steps. Cora Lee, a young teacher whose husband is facing a bone marrow transplant for an aggressive form of leukemia, says I just want to add that you can encourage yourself by saying I ve done hard things before I can do another one. Tim remarks that Cora Lee has a different tone of voice in this suggestion like a good friend or a wise coach who gives you encouragement to draw on your inner strength and resilience without minimizing the difficulty in the situation. When you develop that wise and compassionate part of yourself, you will find many ways that you can help reframe your thinking to take yourself forward. Tim finishes, This is just one way to reframe. There s no one best way. He reads the Kind and Rationale Response from the right column of the table: Who said that I always have to be strong? Sometimes to cry and fall apart is the best thing to do. Then it seems I can find an inner strength, a higher power. By going into suffering you may notice that something comes up from within, as was said earlier. You may find a deeper well to draw from or you may allow yourself to be supported by others. When you stay with the feelings without judging them, you start to find that there is a kind of buoyancy and resilience. 126 The Healing Circle
Mindful of Distressing and Automatic Thoughts It s no use. I don t have the strength to get through this. Inquiry and Insight What emotions follow this way of thinking? Despair, frustration, helplessness Is this a helpful or harmful thought? Harmful Is this thought exaggerated or irrational? Yes Kind and Rational Response Who said that I always have to be strong? Sometimes to cry and fall apart is the best thing to do. Then it seems I can find an inner strength, a higher power. 127 Reframing I can t do it